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Cecal volvulus: A rare post-partum complication

INTRODUCTION AND IMPORTANCE: Cecal volvulus is a rare clinical condition. It is characterized by axial twist of caecum, terminal ileum and the ascendant right colon around their mesenteric pedicles. The main pathophysiologic mechanism is cecal hyper mobility associated to precipitating factor such a...

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Autores principales: Ferjaoui, Mohamed Aymen, Arfaoui, Ramzi, Haddad, Anis, Hannechi, Mohamed Amine, Khedhri, Slim, Neji, Khaled
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8496163/
https://www.ncbi.nlm.nih.gov/pubmed/34607265
http://dx.doi.org/10.1016/j.ijscr.2021.106461
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author Ferjaoui, Mohamed Aymen
Arfaoui, Ramzi
Haddad, Anis
Hannechi, Mohamed Amine
Khedhri, Slim
Neji, Khaled
author_facet Ferjaoui, Mohamed Aymen
Arfaoui, Ramzi
Haddad, Anis
Hannechi, Mohamed Amine
Khedhri, Slim
Neji, Khaled
author_sort Ferjaoui, Mohamed Aymen
collection PubMed
description INTRODUCTION AND IMPORTANCE: Cecal volvulus is a rare clinical condition. It is characterized by axial twist of caecum, terminal ileum and the ascendant right colon around their mesenteric pedicles. The main pathophysiologic mechanism is cecal hyper mobility associated to precipitating factor such as colonic tumor, abdominal mass or pregnancy. Cecal volvulus during pregnancy was reported, but it remains exceptional during postpartum period. CLINICAL PRESENTATION: We report a case of cecal volvulus occurring in 37-year-old woman ten days after cesarean section delivery. She presented an acute abdominal pain associated to vomiting and nausea. X ray imaging and abdominal CT showed a large colonic obstruction, the caecum was dilated and located in the left hypochondrium. An open surgery was performed showing twisted bowels involving the caecum, the ileocecal junction and the right colon. There were necrotic areas on the colonic wall. Right hemicolectomy was performed with end to side ileo-colostomy. The evolution was marked by a serious septic shock causing patient's death. CLINICAL DISCUSSION: Cecal volvulus is a rare condition. Its suggested mechanism associates cecal hyper mobility to a precipitating factor. Increased uterine volume may explain cecal volvulus during pregnancy. In post-partum period, it may be explained by rapid uterine size variation. Cecal volvulus diagnosis is challenging. In fact, its symptoms can be confused with post operative ileus after cesarean section delivery. Delayed management leads to worst prognosis. CONCLUSION: Cecal volvulus during post-partum period is a rare condition, it may be serious in case of delayed diagnosis.
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spelling pubmed-84961632021-10-12 Cecal volvulus: A rare post-partum complication Ferjaoui, Mohamed Aymen Arfaoui, Ramzi Haddad, Anis Hannechi, Mohamed Amine Khedhri, Slim Neji, Khaled Int J Surg Case Rep Case Report INTRODUCTION AND IMPORTANCE: Cecal volvulus is a rare clinical condition. It is characterized by axial twist of caecum, terminal ileum and the ascendant right colon around their mesenteric pedicles. The main pathophysiologic mechanism is cecal hyper mobility associated to precipitating factor such as colonic tumor, abdominal mass or pregnancy. Cecal volvulus during pregnancy was reported, but it remains exceptional during postpartum period. CLINICAL PRESENTATION: We report a case of cecal volvulus occurring in 37-year-old woman ten days after cesarean section delivery. She presented an acute abdominal pain associated to vomiting and nausea. X ray imaging and abdominal CT showed a large colonic obstruction, the caecum was dilated and located in the left hypochondrium. An open surgery was performed showing twisted bowels involving the caecum, the ileocecal junction and the right colon. There were necrotic areas on the colonic wall. Right hemicolectomy was performed with end to side ileo-colostomy. The evolution was marked by a serious septic shock causing patient's death. CLINICAL DISCUSSION: Cecal volvulus is a rare condition. Its suggested mechanism associates cecal hyper mobility to a precipitating factor. Increased uterine volume may explain cecal volvulus during pregnancy. In post-partum period, it may be explained by rapid uterine size variation. Cecal volvulus diagnosis is challenging. In fact, its symptoms can be confused with post operative ileus after cesarean section delivery. Delayed management leads to worst prognosis. CONCLUSION: Cecal volvulus during post-partum period is a rare condition, it may be serious in case of delayed diagnosis. Elsevier 2021-09-30 /pmc/articles/PMC8496163/ /pubmed/34607265 http://dx.doi.org/10.1016/j.ijscr.2021.106461 Text en © 2021 Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Ferjaoui, Mohamed Aymen
Arfaoui, Ramzi
Haddad, Anis
Hannechi, Mohamed Amine
Khedhri, Slim
Neji, Khaled
Cecal volvulus: A rare post-partum complication
title Cecal volvulus: A rare post-partum complication
title_full Cecal volvulus: A rare post-partum complication
title_fullStr Cecal volvulus: A rare post-partum complication
title_full_unstemmed Cecal volvulus: A rare post-partum complication
title_short Cecal volvulus: A rare post-partum complication
title_sort cecal volvulus: a rare post-partum complication
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8496163/
https://www.ncbi.nlm.nih.gov/pubmed/34607265
http://dx.doi.org/10.1016/j.ijscr.2021.106461
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